Marijuana prescription rules, price may change
Nurse practitioners to be added to list of those who can prescribe the drug
OTTAWA— Nurse practitioners could soon be able to prescribe medical marijuana to patients under their care, and the price patients pay for the drug could rise under proposed regulatory changes from Health Canada to its medical marijuana program.
The rise in price for a higher-quality product grown under strict health, safety and security provisions, could price some patients out of the market that could also undergo enormous change under the sweeping proposal now under review. The changes signal the withdrawal of Health Canada from the business of dispensing medical marijuana and potentially save taxpayers $478 million over the next decade.
But it also raises questions for doctors and phar- macists who have been leery of being the final arbiters on handing out a drug that Health Canada says science hasn’t conclusively proven to be of medical benefit to users. Nurse practitioners, who would be able to give the drug to their patients, see the change as exactly what patients need: timely access to a drug that can help those suffering from debilitating diseases, such as cancer, and chronic pain.
“There are nurse practitioners, especially in the areas of chronic care and palliative care, who deal with patients every day … and as part of their practice have the knowledge and skill to prescribe (medical marijuana),” said Claudia Mariano, past president of the Nurse Practitioners Association of Ontario.
In areas where the only care comes from nursing stations, the proposed rules would allow nurse practitioners to prescribe marijuana to patients who wouldn’t have to travel to see a doctor.
“It means they don’t have to go to as many different places to get access to medical mari- juana, that they don’t have to wait as long, that they don’t have to be in pain for intractable periods of time,” said Barb Mildon, president of the Canadian Nurses Association.
To date, nurse practition- ers haven’t prescribed medical marijuana. A recent survey by the Canadian Medical Association found that one-third of doctors who have been asked to prescribe medical marijuana to a patient haven’t done so. And al- though some provinces allow pharmacists to dispense the drug, none have done so.
“Pharmacists are very evidence based. They require a solid understanding of a drug’s efficacy. The evidence to support the efficacy of marijuana … is fairly weak,” said Jeff Morrison, director of government relations for the Canadian Pharmacists Association.
He said there are also concerns for safety — that having the drug stored in local pharmacies could see an increase in break-ins and thefts, similar to what happened when the drug OxyContin was more readily available.
“Having said all of that, because pharmacists do understand that this is a controlled substance and for many Canadians it does represent pain relief, there will be pharmacists that do dispense,” Morrison said.
The changes published Friday would sow the seeds for a “regulated commercial market” where licensed producers could sell marijuana directly to patients.